Definition

What is hoarding disorder?

Hoarding disorder is a persistent difficulty discarding or parting with possessions because of a perceived need to save them. A person with hoarding disorder experiences distress at the thought of getting rid of the items. Excessive accumulation of items, regardless of actual value, occurs.

Hoarding often creates such cramped living conditions that homes may be filled to capacity, with only narrow pathways winding through stacks of clutter. Countertops, sinks, stoves, desks, stairways and virtually all other surfaces are usually piled with stuff. And when there’s no more room inside, the clutter may spread to the garage, vehicles, yard and other storage facilities.

Hoarding ranges from mild to severe. In some cases, hoarding may not have much impact on your life, while in other cases it seriously affects your functioning on a daily basis.

People with hoarding disorder may not see it as a problem, making treatment challenging. But intensive treatment can help people with hoarding disorder understand how their beliefs and behaviors can be changed so that they can live safer, more enjoyable lives.

How common is hoarding disorder?

Hoarding disorder occurs in an estimated 2 to 6 percent of the population. Some research show hoarding disorder is more common in males than females. It is also more common among older adults–three times as many adults 55 to 94 years are affected by hoarding disorder compared to adults 34 to 44 years old. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of hoarding disorder?

The common symptoms of hoarding disorder are:

Excessively acquiring items that are not needed or for which there’s no space

Persistent difficulty throwing out or parting with your things, regardless of actual value

Feeling a need to save these items, and being upset by the thought of discarding them

Building up of clutter to the point where rooms become unusable

Having a tendency toward indecisiveness, perfectionism, avoidance, procrastination, and problems with planning and organizing

Excessive acquiring and refusing to discard items results in:

Disorganized piles or stacks of items, such as newspapers, clothes, paperwork, books or sentimental items

Possessions that crowd and clutter your walking spaces and living areas and make the space unusable for the intended purpose, such as not being able to cook in the kitchen or use the bathroom to bathe

Buildup of food or trash to unusually excessive, unsanitary levels

Significant distress or problems functioning or keeping yourself and others safe in your home

Conflict with others who try to reduce or remove clutter from your home

Difficulty organizing items, sometimes losing important items in the clutter

People with hoarding disorder typically save items because:

They believe these items are unique or will be needed at some point in the future

The items have important emotional significance — serving as a reminder of happier times or representing beloved people or pets

They feel safer when surrounded by the things they save

They don’t want to waste anything

Hoarding disorder is different from collecting. People who have collections, such as stamps or model cars, deliberately search out specific items, categorize them and carefully display their collections. Although collections can be large, they aren’t usually cluttered and they don’t cause the distress and impairments that are part of hoarding disorder.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes hoarding disorder?

It’s not clear what causes hoarding disorder. Genetics, brain functioning and stressful life events are being studied as possible causes.

Risk factors

What increases my risk for hoarding disorder?

There are many risk factors for hoarding disorder, such as:

Personality. Many people who have hoarding disorder have a temperament that includes indecisiveness.

Family history. There is a strong association between having a family member who has hoarding disorder and having the disorder yourself.

Stressful life events. Some people develop hoarding disorder after experiencing a stressful life event that they had difficulty coping with, such as the death of a loved one, divorce, eviction or losing possessions in a fire.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How ishoarding disorder diagnosed?

People often don’t seek treatment for hoarding disorder, but rather for other issues, such as depression or anxiety. To help diagnose hoarding disorder, a mental health professional performs a psychological evaluation. In addition to questions about emotional well-being, you may be asked about a habit of acquiring and saving items, leading to a discussion of hoarding.

Your mental health professional may ask your permission to talk with relatives and friends. Pictures and videos of your living spaces and storage areas affected by clutter are often helpful. You also may be asked questions to find out if you have symptoms of other mental health disorders.

For diagnosis, your mental health professional may use the criteria for hoarding disorder listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.

How is hoarding disorder treated?

Treatment can help people with hoarding disorder decrease their saving, acquisition and clutter, and live safer, more enjoyable lives. There are two main types of treatment that help people with hoarding disorder: cognitive-behavioral therapy (CBT) and medication.

During CBT, individuals gradually learn to discard unnecessary items with less distress, diminishing their exaggerated perceived need or desire to save these possessions. They also learn to improve skills such as organization, decision-making and relaxation. For some people, medications are helpful and may help improve symptoms.

If you or someone you know is experiencing symptoms of hoarding disorder, contact your doctor or mental health professional. In some communities public health agencies can help address problems of hoarding and getting help for individuals affected. In some instances, it may be necessary for public health or animal welfare agencies to intervene.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage hoarding disorder?

The following lifestyles and home remedies might help you cope with hoarding disorder:

Stick to your treatment plan. It’s hard work, and it’s normal to have some setbacks over time. But treatment can help you feel better about yourself, improve your motivation and reduce your hoarding.

Accept assistance. Local resources, professional organizers and loved ones can work with you to make decisions about how best to organize and unclutter your home and to stay safe and healthy. It may take time to get back to a safe home environment, and help is often needed to maintain organization around the home.

Reach out to others. Hoarding can lead to isolation and loneliness, which in turn can lead to more hoarding. If you don’t want visitors in your house, try to get out to visit friends and family. Support groups for people with hoarding disorder can let you know that you are not alone and help you learn about your behavior and resources.

Try to keep up personal hygiene and bathing. If you have possessions piled in your tub or shower, resolve to move them so that you can bathe.

Make sure you’re getting proper nutrition. If you can’t use your stove or reach your refrigerator, you may not be eating properly. Try to clear those areas so that you can prepare nutritious meals.

Look out for yourself. Remind yourself that you don’t have to live in chaos and distress — that you deserve better. Focus on your goals and what you stand to gain by reducing clutter in your home.

Take small steps. With a professional’s help, you can tackle one area at a time. Small wins like this can lead to big wins.

Do what’s best for your pets. If the number of pets you have has grown beyond your ability to care for them properly, remind yourself that they deserve to live healthy and happy lives — and that’s not possible if you can’t provide them with proper nutrition, sanitation and veterinary care.

If you have any questions, please consult with your doctor to better understand the best solution for you.